Individual
DR. MARIO SERRANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4008 W 26TH ST, CHICAGO, IL 60623-3708
(773) 277-0200
(773) 277-0202
Mailing address
4008 W 26TH ST, CHICAGO, IL 60623-3708
(773) 277-0200
(773) 277-0202
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019027920
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356535496
—
IL
Enumeration date
06/02/2009
Last updated
07/09/2009
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